In the method of performing a modified intervastus approach in total knee arthroplasty procedures, a straight incision is initially made in a patient's knee. The incision is located medial to a midline of the patient's knee, in line with the medial border of the tibial tubercle distally extending proximal to the patient's patella. Fascia overlying a lateral edge of the patient's vastus medialis is then incised at a point where the patient's vastus medialis meets the patient's quadriceps tendon. The patient's vastus medialis is separated from the patient's quadriceps tendon and the patient's vastus medialis is elevated off of an underlying capsule. The underlying capsule is incised from a cephalad end to a caudal end thereof, extending medial to the patient's patella.
|
1. A method of performing a modified intervastus approach in total knee arthroplasty procedures, comprising the steps of:
making a straight incision in a patient's knee to expose the patient's intervastus interval between the quadriceps tendon and vastus medialis;
incising fascia overlying a lateral edge of the patient's vastus medialis where the patient's vastus medialis meets the patient's quadriceps tendon;
separating the patient's vastus medialis from the patient's quadriceps tendon along the intervastus interval;
elevating the patient's vastus medialis off of an underlying capsule, thereby preserving the vastus medialis and quadriceps tendon;
incising the underlying capsule from a cephalad end to a caudal end thereof so as to leave a lateral capsular flap to allow for subsequent repair of the lateral capsular flap during wound closure;
repairing the underlying capsule with absorbable sutures; and
repairing fascia of the vastus medialis to the medial edge of the quadriceps tendon.
2. The method of performing a modified intervastus approach in total knee arthroplasty procedures as recited in
3. The method of performing a modified intervastus approach in total knee arthroplasty procedures as recited in
|
1. Field
The disclosure of the present patent application relates to surgical procedures, and particularly to a method of performing a modified intervastus approach in total knee arthroplasty procedures.
2. Description of the Related Art
During a total knee arthroplasty, an orthopedic surgeon removes diseased portions of bone in order to shape the remaining bone to accommodate a knee implant. During the procedure, the surgeon builds the artificial knee inside of the patient's leg, one component at a time, to create a highly realistic artificial joint. Although a wide variety of initial procedures exist for gaining access to the bone, each has its own difficulties and potentials for complications.
The most commonly used approach is the medial parapetellar approach, which is typically seen as being easy to perform, extensile, and easily repaired. However, this approach does not preserve the extensor mechanism and patients may not be able to actively extend their knee or perform straight leg raises soon after the surgery. Using the midvastus or subvastus approach typically permits straight leg raises more rapidly, however, these approaches are not easily extensile, are more difficult for many surgeons to perform, and are more challenging to close with a watertight seal.
The subvastus approach spares the quadriceps tendon and vastus medialis, however, as noted above, the approach is not extensile and may also be difficult to perform in obese and muscular patients, leading to longer operative time and blood loss. It also has the potential for an increased risk of subvastus hematoma, overstretching and ischemia of the vastus medialis, increased incidence of implant malpositioning, and possible detachment of the patellar tendon insertion. The midvastus approach, which separates the distal oblique portion from the proximal portion of the vastus medialis, is likely to damage the innervation of the muscle, which can affect quadriceps function and patellar tracking.
Thus, a method of performing a modified intervastus approach in total knee arthroplasty procedures solving the aforementioned problems is desired.
The method of performing a modified intervastus approach in total knee arthroplasty procedures is an approach in which the arthrotomy is performed with elevation of the vastus medialis off of the underlying capsule. This elevation prevents dissection into either the quadriceps tendon or the vastus medialis muscle. Initially, a straight incision is made that is just medial to the midline, in line with the medial border of the tibial tubercle distally extending just proximal to the patella. This exposes the vastus medialis muscle and the interval between the quadriceps tendon and vastus medialis is then identified.
The fascia overlying the lateral edge of the vastus medialis is then incised where it meets the quadriceps tendon. The muscle is then sharply separated from its insertion onto the tendon and elevated bluntly off the underlying capsule, just enough to allow for later capsular repair. The underlying capsule is then incised from cephalad end to caudal end, extending medial to the patella. Closure may then be performed by repairing the capsule with absorbable suture, and then the vastus medialis fascia is repaired back to the very medial edge of the quadriceps tendon, restoring the anatomy.
These and other features of the present disclosure will become readily apparent upon further review of the following specification and drawings.
Similar reference characters denote corresponding features consistently throughout the attached drawings.
A method of performing a modified intervastus approach in total knee arthroplasty procedures includes a modified intervastus approach for treating the anterior aspect of the knee. This approach minimizes a risk of dissecting the vastus medialis and the quadriceps tendon. The approach is relatively simple to perform, extensile (i.e., compatible with maneuvers such as a quadriceps snip, if required), and easily repaired at the end of the surgery.
The method of performing a modified intervastus approach in total knee arthroplasty procedures includes entering the knee at the junction between the quadriceps tendon and vastus medalis. The patient is positioned supine and a straight incision is made that is just medial to the midline, in line with the medial border of the tibial tubercle distally extending just proximal to the patella. Being just medial to the midline, in many cases, keeps the incision of the direct anterior aspect of the knee, which may facilitate kneeling. The subcutaneous tissues are dissected sharply, ensuring full thickness flaps to preserve the blood supply to the skin. In this manner, as shown in
As shown in
Closure is performed by repairing the capsule with absorbable suture S, as shown in
As shown in
It is to be understood that the method of performing a modified intervastus approach in total knee arthroplasty procedures is not limited to the specific embodiments described above, but encompasses any and all embodiments within the scope of the generic language of the following claims enabled by the embodiments described herein, or otherwise shown in the drawings or described above in terms sufficient to enable one of ordinary skill in the art to make and use the claimed subject matter.
Patent | Priority | Assignee | Title |
11553910, | Feb 09 2022 | SARTAWI, MUTHANA M M A S | Modified intervastus arthrotomy closure method |
Patent | Priority | Assignee | Title |
5947913, | Jan 26 1995 | Method for treating the human knee | |
20140228963, | |||
20180064547, | |||
RU2363404, |
Executed on | Assignor | Assignee | Conveyance | Frame | Reel | Doc |
Date | Maintenance Fee Events |
Mar 20 2018 | BIG: Entity status set to Undiscounted (note the period is included in the code). |
Apr 16 2018 | MICR: Entity status set to Micro. |
Apr 16 2018 | SMAL: Entity status set to Small. |
Apr 18 2018 | MICR: Entity status set to Micro. |
Apr 20 2022 | M3551: Payment of Maintenance Fee, 4th Year, Micro Entity. |
Date | Maintenance Schedule |
Dec 11 2021 | 4 years fee payment window open |
Jun 11 2022 | 6 months grace period start (w surcharge) |
Dec 11 2022 | patent expiry (for year 4) |
Dec 11 2024 | 2 years to revive unintentionally abandoned end. (for year 4) |
Dec 11 2025 | 8 years fee payment window open |
Jun 11 2026 | 6 months grace period start (w surcharge) |
Dec 11 2026 | patent expiry (for year 8) |
Dec 11 2028 | 2 years to revive unintentionally abandoned end. (for year 8) |
Dec 11 2029 | 12 years fee payment window open |
Jun 11 2030 | 6 months grace period start (w surcharge) |
Dec 11 2030 | patent expiry (for year 12) |
Dec 11 2032 | 2 years to revive unintentionally abandoned end. (for year 12) |